With Patients Having More Say, When Do Doctors Say No?

Mat Besch removed his shirt during a recent appointment at the Overland Park Regional Medical Center to reveal a large red welt across his chest.

The welt is a good sign, said Besch’s doctor, Corey Iqbal. It means the teen has been wearing the vacuum-suction device his parents ordered from Europe to try to correct the 3-inch dent in his chest.

Iqbal has performed dozens of surgeries to correct the condition, but Besch is his first patient to try the suction device, which is called a vacuum bell. Iqbal told Besch he couldn’t give him any guarantees it will work, because there’s not much data on it. But he’s game to help them try it, after reviewing the pros and cons.

“I think one of the mistakes we can make as a health care provider in any capacity is when we decide to take a paternalistic approach and (say) ‘This is what it’s going to be,’ as opposed to looking at the patient-doctor relationship as a partnership,” Iqbal said. “My job is to impart expertise, make them experts on the condition, and then they can make an informed decision.”

That philosophy reflects a movement toward patient-centered care that has become widespread in the United States over the last 30 to 40 years.